THE IMPORTANCE OF LATERAL CANTHAL SUPPORT IN LOWER BLEPHAROPLASTY
Author: nathalia kassis
Base Hospital / Institution: Dra Nathalia Kassis clinic
ePoster presentation
Abstract ID: 24-205
Purpose
Lower blepharoplasty is more prone to complications. The most feared complication is retraction. Canthopexy is a great ally to prevent retraction. In patients with an increased risk of retraction, we use lateral canthal support to minimize this risk. The present study reviewed 32 cases operated with lateral canthal reinforcement with transcanthal canthopexy and orbicularis suspension to evaluate when we should perform lateral canthal support associated with lower blepharoplasty.
Methods
Retrospective study of cases of lower blepharoplasty with canthopexy operated between December 2023 and April 2024. The presence of tarsoligamentous laxity, negative vector, negative tilt and scleral show were evaluated through photos and medical records. The surgical technique and complication rate were obtained from the surgical description and clinical notes.
Results
This study involved monitoring the post-operative condition of 32 patients for approximately 60 days after the surgery. We considered postoperative complications to be epiphora 1(3.1%), eyelid malposition 0 (0%), chemosis 4 (12.5%), discomfort in the lateral region 1 (3.1 % ) and asymmetry 2 (6.2%). One patient (3.1%) required simple surgical revision, only removing the stitch improved the discomfort.
Conclusion
Performing lateral canthal support should be considered when the patient has at least one of the four main factors that predispose to retraction (negative tilt, negative vector, scleral show, tarsal ligament laxity). The author believes that canthopexy is a good option due to its easy execution, low morbidity and proven effectiveness in preventing ectropion; although the complications are easy to resolve, it is not advisable to perform it on 100% of patients to avoid unnecessary discomfort to the patient. It is concluded that patients with a positive vector, positive tilt, without scleral show and without laxity do not require canthopexy, while patients who have at least one of these four factors require canthopexy.
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